Abstract: Objective: To investigate the correlation between smoking and coronary atherosclerotic plaque in DSCT angiography. Methods: The patients underwent DSCT coronary angiography, based on questionnaire packet basis, were divided into smoking group and non-smoking group first, then to eliminate high risk family history or diabetes, hypertension, hyperlipidemia and other factors, the rest of 200 cases of smoking group and 200 cases of non-smoking group were used for the experiment. Two groups were observed and compared the incidence rate of plaque, distribution characteristics and types. Results: The incidence rate of 3 coronary artery vascular lesions is 23.0% in smoking group and 7.0% in non smoking group; Incidence rate of diffuse lesions is 46.0% in smoking group, 14.5% in non smoking group, The difference between the two groups were statistically significant(<i<P</i<〈0.05). Comparison of the degree of vascular stenosis: Severe stenosis was 27.5% and occlusion was 6.7% in smoking group; those were 17.1% and 3.7% respectively in non smoking. Plaque types: occurrence rate of mixed plaque is 44.7% in smoking group and 21.9% in non smoking group. The incidence of non calcified plaque was 38.7% in smoking group, 67.9% in non-smoking group, the difference between the two groups were statistically significant(<i<P</i<〈0.05). The Logistic fitting multivariate regression models adjusted for age, sex and body mass index, smoking is an independent risk factor for mixed plaque. Mixed plaque was increased with the smoking index increasing through statistical analysis. Conclusion: DSCTCA can evaluate difference of coronary atherosclerotic plaque accurately between smokers and no-smokers. Incidence rate of mixed plaque in smokers is higher than no-smokers and having more risk prone to cardiovascular events.